Guest guest Posted May 12, 2007 Report Share Posted May 12, 2007 , It has been my experience that success always relates to the person doing the procedure, not usually the equipment itself. This is why the intubation rates vary from service to service and the results of studies are inadequate. It is a tool that can be used when intubation is unsuccessful, not as a first line of intubation. If the tool was as highly rated as an ET tube then it would be first line, as it is less difficult to perform. I personally do not like the tool, especially if you begin to rely on it. Intubation by ET tube is only as good as you make yourself at it. We do intubations daily and very seldom, less than 1%. use the LMA. If you do 2 intubations a year, then who knows what is best for you. I do know that the seal is less reliable. Just my opinion. Andy ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2007 Report Share Posted May 12, 2007 , Do Google searches for stuff like " LMA seal, " and " LMA field placement, " and you'll find a plethora of material. The major problems with LMA are failure to insert it properly so that it seats in the right place to begin with, not using the correct size, inadequate cuff pressure, and ventilation pressures. Displacement can occur but is easily corrected. However, like any airway device, serial placement checks must continually be done, plus monitoring CO2, oxymetry, vital signs, and overall patient appearance and response. ANY DEVICE PLACED IN THE FIELD CAN AND WILL BECOME DISPLACED WITH MOVEMENT!! So it's rally a moot question, isn't it? NO AIRWAY DEVICE CAN EVER BE ASSUMED TO STILL BE IN PLACE! The pressure and weight of the BVM can push a device down out of position. This is particularly true of ET tubes. Also remember that the LMA does not offer complete protection from aspiration. And it may not seal when there is edema present, or trauma that modifies the conformation of the airway. Ventilation pressures must be higher with the LMA in order to achieve the same tidal volume as an ET tube, generally speaking. So even though the LMA seems easy, there are many nuances to using it properly. Check out the Cobra PLA, and the King LP also. There is a study that shows that the Cobra may offer a better seal in some patients than the LMA. The other thing to look at is the new LMA FastTrach. New toys come out almost daily. No ONE airway is suitable for all patients!!! I submit that if you only have available ET intubation or surgical intervention, you're a plaintiff's lawyer's dream. I suggest that if you have only the Combitube available, same thing. Airway is THE SINGLE MOST IMPORTANT ASPECT OF EMERGENCY CARE, and we spend less time teaching it than we do taking blood pressures. As the SLAM Motto says, " IF YOUR PATIENT CAN'T BREATHE, NOTHING ELSE MATTERS .. " It's good that you're examining the efficacy of the LMA. BRAVO! But just remember that all airway devices are mischievous and will come unstuck on you whenever they possibly can. Gene G. > > Does anyone have any studies on the success of LMA placement in > the field? I'm trying to see if the LMA holds a proper seal when > patients are moved or immobilized. > > Lee > EMSC,FF/EMI- > > > ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2007 Report Share Posted May 12, 2007 Does anyone have any studies on the success of LMA placement in the field? I'm trying to see if the LMA holds a proper seal when patients are moved or immobilized. Lee EMSC,FF/EMI-I Quote Link to comment Share on other sites More sharing options...
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